In no more than three sentences, describe the project for which you are requesting funds.*

Grant Application - Part II

Describe the proposed project in detail, including your goals and objectives.*

How does this project support CCF's mission?*

Specifically how does the project/program advance one or more of CCF's three core focus areas listed above?*

Discuss the community need for the project, the benefits for the community as a result of the project and the community support of the project.*

Will this project take place within the City of Clive? If not, state the percentage of the program which will take place within city boundaries.*

Include the target population and the expected number of people you will serve.*

How would or does this project/program include community partners? How would project/program raise the visibility of CCF and the community of Clive?*

Outline other resources or partners identified to assist with the project, and other funding applied for or secured for the project.*

In the first question you described the project goals and objectives. How will you measure the impact of the project and if the goals and objectives were reached?*

What is your timeline for this project?*

Project Budget. Please itemize the items needed to complete the project and their costs. Also show the source and amount of the funds used to cover the costs. This should incude the amount of your request from the Clive Community Foundation as well as other funders.*

Income

Sponsor Cash:

Source:

Amount:

Federal Gov. Grants:

Source:

Amount:

Polk County Grants or State Grants:

Source:

Amount:

Private Foundations:

Source:

Amount:

Sponsor In-Kind:

Source:

Amount:

Private In-Kind:

Source:

Amount:

Other Income:

Source:

Amount:

CCF Request:

Source:

Amount:

Total Income from above:

Expenses

Land Purchase:

Source:

Amount:

Professional Services:

Source:

Amount:

Construction Costs:

Source:

Amount:

Equipment Purchase:

Source:

Amount:

Construction Supplies:

Source:

Amount:

Training Costs:

Source:

Amount:

Personnel Costs:

Source:

Amount:

Other Expenses:

Source:

Amount:

Total Expenses from above:

Part III - Approval from Applicant Organization

We approve submission of this grant request and certify that the purpose of this request is charitable and that monies received from the Clive Community Foundation will be used solely for the project stated in this application.

Applicant Name:

Date Submitted:*

Part IV - Attachments

Attachments:*

Please attach the required documents in pdf format:
Copy of IRS Federal Income Tax Exempt Letter, List of Board of Directors, other items such as bids or estimates.